Background

China has the largest number of overweight and obese (ov/ob) people in the world as about 50% of adults and 20% of children are overweight or obese. The rates in China have been increasing rapidly in the past 3 decades. Supported by the United Nations Children’s Fund (UNICEF), we examined obesity trends, national policies and intervention programs on childhood obesity in China since 1949, compared these with related international recommendations and practice, and provided recommendations for future efforts.

Methods

Literature search and expert consultation were conducted to obtain related data. About 20 leading international and domestic experts were consulted.

Results

In China ov/ob prevalence increased from 29.9% in 2002 to about 46.0% in 2014; from 5.8% in 1991 to 9.5% in 2011 in preschool children (2-6 y), and from 8.0% in 1985 to 27.9% in 2014 in school children (7-18 y). Development of national policies on childhood obesity prevention experienced 3 stages: 1) 1949-1994: Childhood ov/ob were low, related research and national surveys emerged; 2) 1995-2010: childhood ov/ob increased rapidly, related policies and intervention programs were gradually established; 3) 2011-: policies focused on improving nutrition status of children in poor areas, establishing monitoring systems, but effectiveness of the polices was not assessed. Nine major national intervention programs were identified. Mainly they focused on preschool or school children and on promoting physical activity (eg, “The Happy 10 Minutes Program”) and healthy eating (eg, School Meal Program). No interventions targeted at improving environments. Recently we published the “China Blue Paper on Obesity Prevention and Control” to promote obesity interventions in China.

Conclusions

Ov/ob rates have increased rapidly in China. Compared to many industrialized countries, national policies and interventions on childhood obesity in China are limited. Increasing efforts are made to fight the epidemic.